Risk Factors for Rehospitalization in Children with Sepsis

One-third of children who recover from sepsis are at risk of rehospitalization at 90 days after discharge, according to a recent study published in the July 2023 issue of the journal Pediatrics.1

 A team of researchers from the United States collaborated on this retrospective observational study to ascertain the frequency and the probable causes of readmission within 90 days of discharge from the hospital. For this they examined electronic health records of 3464 children who had been admitted to hospital, from January 2011 to December 2018, either for sepsis or septic shock and were discharged from the hospital.

The rehospitalization rate 7 days after discharge following the index hospitalization was found to be 7%. The 30-day rehospitalization rate increased to 20%, while at 90 days, the rehospitalization rate jumped to 33%. Infants, children with chronic comorbid diseases, lower hemoglobin and elevated blood urea nitrogen (BUN) at the time of diagnosis of sepsis and those who continued to have low white blood cell count (≤2000 cells per microliter) were at higher risk of requiring readmission to hospital at 90 days. The authors however noted that “these variables explained only a small proportion of overall risk (pseudo-R2 range 0.05-0.13) and had moderate predictive validity (area under the receiver operating curve range 0.67-0.72) for readmission”.

This study has identified patient-related factors associated with readmission after discharge from the initial hospitalization. Infections were the most common cause for children getting admitted to hospital again.

Reference

 1.     Hannah S Dashefsky, et al. Frequency of and risk factors associated with hospital readmission after sepsis. Pediatrics. 2023 Jul 1;152(1):e2022060819. doi: 10.1542/peds.2022-060819.